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Mission Statement (and disclaimer)

* To inform, educate, inspire colleagues and general public by sharing my own experiences, observations, thoughts, and insights drawn from my life and career in medicine and surgery.

* To explore my life and surgical career, as my journey progresses.

* To pose questions, address controversies, frame debate and discussion about/around topics, events, and issues that touch medicine and surgery, and the physicians and surgeons, institutions, and people involved and affected.

This will mainly be framed in the context of personal essays, discussions, conversations, observations (albeit one-sided).

I speak only for myself, the thoughts and opinions are mine; if I quote or borrow from others, appropriate attribution will be made.The educational and other institutions, groups, and organizations I have been and continue to be involved with have not sanctioned or approved the content, my comments here should not and do not reflect their opinions or represent them in any way. Likewise, I do not deign to represent my peers and colleagues. With that said, I hope that I respect and honor them all here in this place.

Posts and the information shared should not be taken as medical or treatment advice; any concerns or problems should be discussed and evaluated with your own physician or health care provider.

Comments are welcome, but will be reviewed and approved before posting.

A Matter of Faith

Spring ushers in major holidays in many faiths and religions. Western Easter has just passed, we are in the midst of Passover, and coming to the close of Holy Week with Good Friday for Eastern Orthodox Christians, making final preparations for their own Easter celebration.

The rites of spring and the vernal equinox, new life and rebirth are springtime themes and touchstones across many cultures. Faith is important to many people and across many cultures and religions. I would assert faith is even important to atheists and agnostics, and those without a formal religious tradition.

Faith is important in medicine, too. For in medicine we treat people, and understanding people and the influences of the greater culture and society—and faith and religion— is an important part of that understanding and the expectations and goals of care.

In considering faith and its role in medicine, it is also useful to think about it beyond the constraints of formal ritual and organized religion. In fact, faith itself operates distinctly, even independent of religion, although religion provides framework and structure, tradition and ritual for that faith.

In its most basic sense, faith is a kind of trust, whether in a being or entity beyond human experience, or faith in people, in the tangible, even in processes and procedures, institutions, history and tradition. Faith is based on trust; it is a kind of trust that bridges from the known to the unknown, from knowledge and understanding to the uncertain and unknown and poorly understood.

As physicians, we ask our patients to trust us, as we trust them too. This trust is built on a foundation of communication, and on the relationship that grows out of the trust and communication. But in fact we are also asking for their faith— in us, and in the treatments and procedures, the advice and recommendations, the systems and institutions that are a part of modern medicine. The faith is necessary, for no matter how much we inform and explain, we possess a special set of knowledge and skills that has taken many years to acquire, and continues to expand and evolve.

The patient must trust us, trust our knowledge and skills, and have faith.

Trust and faith are essential for a functioning physician-patient relationship. They are not amenable to quantification and measurement, and I don’t think they can be tested with randomized prospective studies or meta-analysis. But each of us physicians have witnessed the importance of attitude and confidence in the treatment and the plan, and the physician. This is faith.

We see the consequences when faith breaks down, when trust is broken. Is patient compliance affected? Are there more checks and balances, forms and oversight, checklists and measures? Certainly our systems and processes, treatments and techniques need testing and monitoring to improve and refine. But not all of these monitoring schemes are aimed at process improvement or optimizing patient care. It is a fine line, and a slippery slope when trust is lost or faith broken.

Faith is based on trust. In medicine is based on communication, and ultimately on the physician-patient relationship. This relationship and its unique intimacy are what make the interaction between physician and patient so very different from the provider-client construct of business and commerce. So let Spring and the holidays remind us, give us strength and resolve in our efforts to protect and preserve the physician-patient relationship. Let us not forget this trust as we honor this relationship, and remember to keep the faith.

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2 thoughts on “A Matter of Faith”

Steven Galanissays:

You are too modest to state this directly- but there is no relationship with higher stakes than the physician patient relationship. The modern patient guided by faith facing a life-threatening illness bends the knee but also listens to a competent doctor. Wisdom is eternal! (: